A primary care model to improve quality of life for older autistic people
Authors: Richard C Armitage
Journal: The Lancet Healthy Longevity (2023)

The Article by Liu and colleagues1Liu S Larsson H Kuja-Halkola R Lichtenstein P Butwicka A Taylor MJ Age-related physical health of older autistic adults in Sweden: a longitudinal, retrospective, population-based cohort study.Lancet Healthy Longev. 2023; 4: e307-e315Summary Full Text Full Text PDF Google Scholar and the accompanying Comment by Howlin,2Howlin P Increased risk of physical health problems among older autistic adults.Lancet Healthy Longev. 2023; 4: e293-e294Summary Full Text Full Text PDF Scopus (0) Google Scholar reporting on older autistic adults’ substantially increased risk of age-related physical conditions compared with non-autistic adults, stresses the “urgent need to understand the underlying reasons, design targeted screening and intervention programmes, and promote older care to enhance quality of life for older autistic people”. Although the study was in the Swedish population, the English example of targeted screening and intervention programmes for this patient group could provide be of practical utility. The prevalence of autism in England—around 0·1%, and higher in men than in women3NHS DigitalHealth and care of people with learning disabilities, experimental statistics 2021 to 2022: coverage and prevalence. Dec 8, 2022.https://digital.nhs.uk/data-and-information/publications/statistical/health-and-care-of-people-with-learning-disabilities/experimental-statistics-2021-to-2022/coverage-and-prevalenceDate accessed: June 8, 2023Google Scholar—is similar to that in Sweden.1Liu S Larsson H Kuja-Halkola R Lichtenstein P Butwicka A Taylor MJ Age-related physical health of older autistic adults in Sweden: a longitudinal, retrospective, population-based cohort study.Lancet Healthy Longev. 2023; 4: e307-e315Summary Full Text Full Text PDF Google Scholar In England, those aged 14 years or older with a learning disability (including a diagnosis of autism) who are registered with a primary care practice's learning disability register are automatically invited for an annual health check,4NHSAnnual health checks: learning disabilities.https://www.nhs.uk/conditions/learning-disabilities/annual-health-checks/Date accessed: June 8, 2023Google Scholar which includes, among other things, recording BMI, blood pressure, and smoking status, reviewing vaccination history and existing chronic conditions (such as asthma, epilepsy, and constipation), and screening for type 2 diabetes and hyperlipidaemia.4NHSAnnual health checks: learning disabilities.https://www.nhs.uk/conditions/learning-disabilities/annual-health-checks/Date accessed: June 8, 2023Google Scholar In 2018–19, the proportion of eligible patients in England who received this annual learning disability health check was 68·9% for those aged 65–69 years, 68·0% for those aged 70–74 years, and 65·8% for those aged 75 years or older.3NHS DigitalHealth and care of people with learning disabilities, experimental statistics 2021 to 2022: coverage and prevalence. Dec 8, 2022.https://digital.nhs.uk/data-and-information/publications/statistical/health-and-care-of-people-with-learning-disabilities/experimental-statistics-2021-to-2022/coverage-and-prevalenceDate accessed: June 8, 2023Google Scholar The England National Health Service Long Term Plan, published in January, 2019, aimed to achieve adhesion to the annual health check for those with learning disabilities of at least 75%;5NHSThe NHS long term plan. Section 3·31. January, 2019.https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdfDate accessed: June 8, 2023Google Scholar by 2021–22, uptake of the health check in these age groups had increased to 79·0%, 78·8%, and 75·9%, respectively. Although research is needed to establish the impact of this increased uptake on age-related physical conditions for older autistic people, the existing English primary care model of targeted screening and intervention programmes, as called for by Liu and colleagues, could be of use to other nations that wish to improve quality of life for older autistic adults. I declare no competing interests. Age-related physical health of older autistic adults in Sweden: a longitudinal, retrospective, population-based cohort studyOur data indicate that older autistic adults are at substantially increased risk of age-related physical conditions and injuries compared with non-autistic adults. These findings highlight the need for collaborative efforts from researchers, health services, and policy makers to provide older autistic individuals with the necessary support to attain healthy longevity and a high quality of life. Full-Text PDF Open AccessIncreased risk of physical health problems among older autistic adultsAlthough research involving autistic adults has been expanding steadily over the past 10 years, studies of older autistic individuals (generally defined as those aged 50 years and older) still constitute only around 0·4% of all published autism research.1 Shengxin Liu and colleagues’ study of physical health in older autistic adults2 is, therefore, a welcome addition to the literature. The increased risk of mental health disorders co-occurring with autism has been recognised for some time,3 but awareness of the elevated risk of physical health problems,4 higher rates of premature mortality,5 and of the many barriers that autistic people face in accessing adequate health care is now growing as well. Full-Text PDF Open Access